HPV and Steroids

[SebastianMoe]

Hi doctors,

I'm a 21 year old male currently dating a 20 year old female.  Last October she was told by her doctor that she has HPV, low to high risk intraepithelial lesions.  The doctor at her school decided she didn't need anything done and didn't need to come back for an exam for another year.  That August BEFORE she was diagnosed, we both performed oral sex on each other.  I then left at the end of August for an internship in Washington D.C.  My girlfriend came out to visit and we engaed in oral sex (mutually) yet again.  She came before she knew she had HPV so we both didn't know.  While in D.C. I developed some cobblestoning on the back of my throat and have had a few sore throats since that time up until now (I still have them.)  I went through a couple different kinds of antibiotics and nothing changed.  Then in January before I returned home, my doctor put me on a dose of oral Prednisone for 2 weeks time.  The dose was either 60 or 100 Mg (can't remember) which was slowly tapered off over 2 weeks time.  This still didn't do anything and the bumps are still there.    

My main concern is not only the bumps and the oral sex, but the fact that I was using a potent oral steroid while I was around/exposed to my girlfriend's HPV.  We kissed often, and had unprotected and protected sex.  Don't oral steroids lower your immune system?  Also, I'm on Nasacort right now as the latest attempt to try and rid me of the bumps.  Isn't this also a steroid?  The directions said to limit bacteria, virus exposure.  Now I'm afraid I might have harmed my body's immune system.  And these bumps are starting to scare me a bit.    

Is it okay to kiss/have sex with her even though  I'm on the steroid nasal spray?  The doctor wanted me to use the Nasacort steroid spray for 4-6 weeks.  Also, should I be concerned about my exposure to her HPV while I was taking Prednisone?  Lastly, any thoughts on the throat bumps?    

Thanks

[Edward W Hook, MD]

Tenderness in the groin area may be a manifestation of a swollen lymph node.  Hard to really tell without an examination.  Either way, this is not a sign of either HPV or cancer in the region qand is not something to worry about from that perspective.  EWH

[SebastianMoe]

Thanks Dr. Hook,

My girlfriend was told she has the high risk type, and thus she doesn't have any visible warts.  

An ENT said it was cobblestones and put me on the Nasacort but it seemed like he didn't know much about HPV when I asked him questions and he was surprised the Prednisone didn't do anything.  That's why I was concerned regarding the use of a steroid inhaler for a seemingly long time of 4-6 weeks and the fact that they're still there after all these months.  And to boot, he actually worried me more by saying engaging in sex with someone who has HPV is a risky behavior.  

One more quick question probably unrelated to HPV.  Is it normal to feel a slight pain when one pushes on the region around the penis i.e. groin/pubic region.  I felt some slight pain there a few days ago and when I push gently on the left side of pubic/groin area it hurts a bit.  This is probably just due to the lymph nodes being in that area and is nothing to be worried about or cancer/HPV related.  But just thought I'd run it by you in my closing comment.  

Thanks again doctor.

[Edward W Hook, MD]

HPV is indeed transmitted through direct contact so there is a modest chance that you acquired HPV during exposure to your GF.  You did not say if she had visible warts or not (i.e. her HPV might not be visible but might have been detected by pap smear).  the reason for asking for this clarification is because visible lesions tend to cause visible lesions when transmitted  while those that are not visible usually are not visible when tranmitted as well.   I don't think the bumps in the back of your throat are likely to be HPV and if your GF's infection was not manifest as visible warts, then it is still more unlikely that your lesions are warts.

Another word about HPV. If you got it, welcome to the club.  Just about every sexually active person will get an HPV infection at some point after starting to have sex.  The good news is that these very common infections RARELY cause problems and tend to be self-limited, resolving in about 6 months after infection without treatment in the vast majority of persons.

As for steroids, while steroids may compromise a person's ability to fight certain infections while one takes them, they do not act in the same way to greatly increase vulnerability to infection, thus I doubt that being on steroids increased your risk for HPV acquisition.  Further, there is no reason to think that steroids harmed your immune system.

Finally the bumps. Without examining you it is not possible to say but I will point out that there is a great deal of lymphoid tissue in the mouth and throat which, when activated may look like "bumps",  If the Nasacort doesn't work, you may wish to see and ENT physician.  EWH